Do You Know What Your Medicare Options Are?

Posted: October 21, 2024, 2:53PM

Annual Open Enrollment for Medicare runs from October 17 - December 7. This is when you can change your Medicare health or drug coverage for 2025. You can join, switch, or drop a Medicare Advantage Plan or Medicare drug plan, or switch to Original Medicare.

But - do you know what that means? Do you know the ABCs of Medicare? Do you know what a Medicare Supplement / Medigap is? Do you know what Medicare Advantage covers?

There are several things to consider and, of course, there are often special considerations!

Here are some basics:

Medicare Advantage Plan: You must have Part A and Part B to enroll in a Medicare Advantage Plan (MA) or Part C. (A + B = C) MA plans are Medicare-approved, usually include Part D (prescription) coverage, and may offer limited vision, dental, hearing, and other added benefits.

Medicare Supplements or Medigaps: Since original Medicare doesn't pay all of the costs of covered services, Medicare Supplements (Medigaps) can help pay some of the remaining costs. (Supplies and other such as copays and deductibles) You can purchase a Medicare Supplement or Medigap when you are new to Medicare. In most states, there are conditions under which you can change a Medicare Supplement or Medigap. Most often, after the allowed enrollment period, a change of Supplements may cost more or you may not be able to buy a Medigap policy. Some states allow changes under certain conditions and have a 'birthday rule'. Medicare.gov can help you determine changing Supplements.

Part D or Prescription drug coverage: Medicare Advantage plans usually include Part D. Medicare supplements or Medigaps, do NOT. There are several products with differing coverage and differing cost. Prescription coverage depends on the drug. Is it generic? Is it brand?

Just to let you know, product benefits that are available in one state are not necessarily the same in other states. Some plans or products are offered in one state but may not be available in a neighboring state.

There are different considerations for those who reach Medicare age. Are you still working? Do you need to defer benefits? Are you aging into Medicare (turning 65)? You can read the Medicare and You 2025 Handbook which will answer a lot of questions.

There are State Health Insurance Information Programs in all states. Consult the SHIP counselors to help you determine what is right for you. SHIP counselors do not represent any insurance product and are there to help consumers without prejudice. SHIP counselors help consumers in their own state.

You can call 304 233-6300 in the northern panhandle of WV or 877 987-4463 to find the SHIP counselor in your WV county. In Belmont County, OH, call Ohio Hills Health Services at 740 425-5147. For other Ohio counties, call 800 686-1578. Outside these areas, you can find your SHIP counselor here.

Medicare.gov is a valuable resource for information on Medicare options.

You may want to consult an insurance broker: someone who offers several insurance products. They can help you determine the insurance options that are best for you. Medicare Advantage? Original Medicare + a Medicare Supplement / Medigap + a Part D plan? Brokers know the variations in the products and also know the differences in products from state to state.

You can read some comparisons of Medicare Advantage plans and Medicare Supplements in this Forbes article.

Ask the questions! The resources listed offer a lot of information that is unbiased. SHIP programs and brokers have information on many options. Find out what is best for you!